The objective the NHLBI Network for Cardiothoracic Surgical Investigations in Cardiovascular Medicine (Network) is to improve our understanding of surgical cardiovascular disease through collaborative research, and therefore improve the delivery of new therapeutic options in order to improve the health of the public. In order to achieve this, we propose to establish a collaborative relationship between ECU Brody School of Medicine Division of Cardiothoracic Surgery and the Duke University Cardiothoracic Surgery, Cardiac Anesthesiology and Cardiology and Anesthesia Divisions to form a combined Clinical Center ( Duke CC) for the Network. There is a longstanding history of collaboration between colleagues in the Duke and ECU programs. The combination of these two programs, creates a high-volume CC with comprehensive surgical expertise and unique opportunities to investigate health care disparities. The ECU program ideally compliments the clinical and research profile of the CT Division at Duke. The Duke/ECU CC will collaborate with other CCs, the Data Coordinating Center (DCC), the Steering Committee, and the NHLBI group to achieve Network goals. We will work willingly, cooperatively, and collaboratively with other CCs and with the DCC in all aspects of the Network. The investigators and clinicians in the Duke CC have a strong commitment to advancing patient care through high quality clinical research, and an established track record of success. Our dedicated, collaborative teams combines a broad array of clinical, research, and operational skills that collectively will make a major contribution to the overall success of the Network, and will ensure that all CC goals are met according to timelines and goals set by the NHLBI. The Duke CC has the following Specific Aims: 1. Commitment to Clinical Research and Collaboration with other Network CCs and the DCC. 2. Leverage the infrastructure of the Duke Clinical and Translational Research Institute (DCTRI) to ensure efficient resources are available to support the Duke CC. 3. Participate in the proposal, design and execution of Network Protocols as a Network CC. 4. Develop a Clinical Research Skills Development Core. To accomplish these goals, we have assembled an outstanding team of experienced investigators with access to an exceptional array of resources for this Network. The successful achievement of these aims will be a significant contribution to the Cardiac Surgery Network and the overall care of patients with surgical cardiovascular disease. (End of Abstract)